Medicare Advantage Risk Score Calculation API Documentation
Overview
The Medicare Advantage Risk Score Calculation API calculates risk scores for Medicare Advantage beneficiaries using the CMS Hierarchical Condition Category (CMS-HCC) Model. The API provides insights into predicted healthcare expenditures, helping health plans optimize resource allocation and improve the overall quality of care.

API Endpoints
Calculate Risk Score
URL: /api/risk-score

Method: POST

Request Body:

Demographics (required): An object containing demographic information, including age, sex, and disability status.
DiagnosisCodes (optional): A list of diagnosis code objects, each containing a diagnosis code and its relative USCDI class.
PaymentYear (required): The payment year for the risk score calculation.
Response:

A JSON object containing the calculated risk score.

Data Models
RiskCalculationRequestModel
The main request model that includes demographic details and a list of diagnosis codes.

DemographicsModel
A model representing demographic details, such as age, sex, and disability status.

DiagnosisCodeWithUscdiClass
A model representing a diagnosis code and its relative USCDI class.